A Millennium of Dentistry: A Look Into the Past, Present and Future of Dentistry

A Millennium of Dentistry: A Look Into the Past, Present and Future of Dentistry

Oral disease has been a problem for humans since the beginning of time. Skulls of the Cro-Magnon people, who inhabited the earth 25,000 years ago, show evidence of tooth decay. The earliest recorded reference to oral disease is from a Sumerian text (circa 5,000 B.C.) that describes "tooth worms" as a cause of dental decay. No one can deny that dentistry has made tremendous strides over the years.

"Things have certainly changed from the Middle Ages to the early 1700s, when most dental therapy was provided by so-called ‘barber surgeons‘," said Academy of General Dentistry spokesperson Eric Curtis, DDS, renowned dental historian. "These jacks-of-all-trades would extract teeth and perform minor surgery, in addition to cutting hair, applying leeches and performing embalming."

Dental practitioners migrated to the American colonies in the 1700s and devoted themselves primarily to the removal of diseased teeth and the insertion of artificial dentures. In the 1800s, dental practices included such duties as extracting teeth with a turnkey (a primitive tool like a ratchet wrench, used for extracting teeth), cleaning the teeth with scrapers and removing cavities with hand instruments. The filling materials used then were tin, gold foil, lead and silver. Dentures were carved from ivory or fashioned from the teeth of cattle.

In the past century, human life expectancy has almost doubled and immense changes in quality of life have occurred. Some of the changes that have had a positive impact on dentistry include increased emphasis on personal hygiene; availability of antibiotics, vaccines and fluoridation; improved diets; electricity and heating; the X-ray; and the telephone, computers and the Internet. Present-day dental accomplishments include the use of silver and white fillings, air-abrasion techniques for the filling of cavities and more.

An increase in people over the age of 65 who retain their teeth also has affected dentistry, with more attention being paid to the complex needs of this older population. A more knowledgeable and affluent U.S. population has resulted in an increase in dental visits for an improved smile, in sharp contrast to the reasons for dental visits 100 years ago, i.e., to alleviate pain and restore function. This consumer trend will strengthen in the next century as more people retain their healthy teeth for a lifetime.

"No one can know for certain what the future of dentistry will hold," stated Dr. Curtis. "I think we will see an integration of dentistry into comprehensive health care and an increased focus on the link between oral health and overall health as we enter the 21st century. Computer-assisted technology for diagnosis and treatment, and gene-mediated therapeutics, which alters the genetic structure of teeth to make them impervious to decay, will likely play an important role in the future of dentistry," said Dr. Curtis.

The beginnings of dentistry

2900 B.C.E.Egyptian lower jaw demonstrates two holes drilled through the bone, presumably to drain an abscessed tooth. Egyptians were the first to designate a doctor that specializes in treating teeth.

2700 B.C.E.Evidence that the Chinese used acupuncture to treat pain associated with tooth decay.

1700 B.C.E.Ancient Egyptian papers called the Ebers papyrus, which date back as far as 3700 B.C.E., contain references to diseases of the teeth, as well as prescriptions for substances to be mixed and applied to the mouth to relieve pain.

1300 B.C.E.Aesculapius, a Greek physician, first writes about the concept of extracting diseased teeth.

500 B.C.E.Hippocrates and Aristotle write of ointments and sterilization procedures using a red-hot wire to treat diseases of the teeth and oral tissues. They also speak of tooth extraction and the use of wires to stabilize jaw fractures and bind loose teeth.100Roman medical writer Celsus writes extensively of oral diseases as well as dental treatments such as narcotic-containing emollients and astringents.

Visions of the future in the 1600 and 1700s

1685First dental textbook is published in English by Charles Allen titled "The Operator for Teeth."

1728Pierre Fauchard publishes his master work, "The Surgeon Dentist," which describes for the first time a vision of dentistry as a modern profession.

1785John Greenwood, who served as George Washington's dentist helps raise public awareness about porcelain teeth.

The enlightening 1800s

1816Auguste Taveau develops the first dental amalgam, or fillings, made from silver coins mixed with mercury.

1839Charles Goodyear discovers vulcanized rubber. This discovery made denture bases, previously fashioned out of gold, affordable for the average person.

1840Horace Wells first demonstrates the use of nitrous oxide for sedation.

1840Thomas Morton first demonstrates the use of ether anesthesia for surgery.

1840Horace Hayden and Chapin Harris invent modern dentistry. They:

Founded the first dental school, the Baltimore College of Dental Surgery.

Invented the modern doctorate of dental surgery (DDS) degree.

Started the world's first dental society, the American Society of Dental Surgeons, which eventually formed into the American Dental Association.

1870sBaked porcelain inlays come into use for filling large cavities.

1866Lucy Hobbs, the first woman to obtain a DDS degree, graduates from Ohio College of Dental Surgery.

1871James Beall Morrison patents the first mechanized dental drill. This drill twirled very slowly and a filling could take several hours to complete.

1890sWilloughby Miller first describes the microbial basis of dental cavities, which initially raised cavity-prevention awareness and led the way for oral care companies to market at-home oral health care products.

1895G.V. Black standardizes both cavity preparation and the manufacturing process of silver fillings.

Scientific advances in the 1900s

1907Novocain is introduced into U.S. dental offices by Heinrich Braun.

1907William McTaggart invents his "lost wax" casting machine, which allows dentists to make precision cast fillings to fill a cavity.

1926The Gies Report, urging dental schools to become university-based, is issued by the Carnegie Foundation.

1929Penicillin is invented, having a major impact on treatment protocols for dental infections.

1945Grand Rapids, Michigan, is the first city in the world to fluoridate drinking water.

1955Michael Buonocore invents white (composite) fillings. He also described a method of bonding resin to tooth enamel, enabling dentists to repair cracked enamel on front teeth.

1957John Borden invented a high-speed, air-driven hand piece, increasing drill power from the traditional 5,000 rpm (rotations per minute) to 300,000 rpm, which shortens the time to prepare a tooth for a filling to a matter of minutes.

1958The first fully reclining dental chair is introduced, allowing more patient and dentist comfort and enabling the dentist to have an assistant help with procedures.

1990s "Invisible" braces, or aligners, are introduced in the United States, offering an alternative to traditional braces.

Into the 21st century

Integrating dentistry into comprehensive health care.

Increased focus on the link between oral health and overall health.

Gene-mediated therapeutics, which means altering the genetic structure of teeth to make them impervious to decay. Some researchers are now investigating the possibility of growing new tooth structure around weakened enamel.